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Empowering Frontline Heroes: A New Era for Community Healthcare

By Lusayo Banda, Communications Manager-Amref Health Africa Malawi

For over a decade, Paul Chakamba has dedicated himself to serving his community as a Health Surveillance Assistant (HSA), focusing on providing essential healthcare to children under five. Despite his passion and commitment, Paul, like many other HSAs in Malawi, never received formal training beyond the basic 12-week preservice training that is standard for his role. This limited his ability to offer a broader range of services.

When Paul learned that he was one of the 497 HSAs selected to undergo a new, comprehensive one-year training course in community health, his excitement was overwhelming.

“I could not believe it when I was told I had been selected for this training. I’ve worked for many years, but I knew I needed formal training to provide even more services in my community,” Paul shared with pride.

HSAs like Paul have long been the backbone of Malawi’s healthcare system, delivering critical services such as immunization, family planning, and basic medical care. However, HSAs were providing these services without the recognition by Medical Council of Malawi (MCM) a regulatory body for health services delivery. There is also an increasing complexity of health challenges in rural communities surpassing the basic training they received, leaving many HSAs unequipped to meet the evolving needs of their patients.

Recognizing this gap, Amref Health Africa Malawi, with financial support from the Pfizer Foundation, launched a groundbreaking initiative aimed at strengthening the community health workforce. For the first time, 497 HSAs across five districts of Mangochi, Machinga, Zomba, Chikwawa, and Salima are receiving formal, comprehensive training, recognized by the Medical Council of Malawi.

This one-year program, running from November 2023 to October 2024, will formally certify HSAs as Community Health Assistants (CHAs). The training covers everything from advanced clinical skills to patient-centered care, ensuring that these frontline health workers are better equipped to serve their communities. This initiative is projected to benefit over 500,000 people in the participating districts.

“The training has been incredibly beneficial,” Paul said. “I’ve gained new skills in conducting village clinics and identifying danger signs in children. This certificate will open new doors for me, and I hope to continue my studies to obtain a diploma.”

Monica Dombo, an HSA for 14 years, echoed Paul’s enthusiasm. “Before, it was hard for me to treat young children. But now, I can diagnose them more effectively. Being one of the first HSAs chosen for this training makes me feel special, and it motivates me to do my job in a more professional way.”

Their newly acquired skills aren’t just benefiting the HSAs, the ripple effects are already being felt in the communities they serve. Village clinics are becoming more efficient, and patients are noticing the difference.

Thokozani Sikweya, a mother of one, expressed her gratitude for the improved services. “The village clinic has been a blessing. We no longer have to travel far to access healthcare. When my child falls ill, I know I can bring them here and receive good care,” she said.

Young Samanyika, Amref Health Africa Malawi Project Manager, highlighted the importance of this formal training. “Previously, HSAs were not recognized by the Medical Council of Malawi because they lacked the one-year training required. This initiative changes that. Once certified, HSAs will have enhanced skills and knowledge, leading to better patient outcomes and an overall improvement in the quality of care provided.”

One of the women benefitting from the village clinics conducted by HSAs in Chikwawa
Paul Chakamba assists a child during a health clinic.

As Paul, Monica, and Frank prepare for graduation, they have not only acquired valuable skills but also developed a renewed sense of confidence and pride in their work.

Amref Health Africa

Amref Health Africa teams up with African communities to create lasting health change.

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